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10 NE 98 St (2)Date Z--/ Job Address Legal Description/ ��•n �s Owner / Lessee / Tenant PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Owner's Address /4 ,V Z5. 9 - 4 , Contracting Co. Qualifier SS# State # Municipal # Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION "e /J4G e ( 1' L fa /(jt 9/455 Square Ft. 1 -(6d 'T API c S, 1 y v ct WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Signature of owner and /or Condo President gna eye r Owner- Builder Date: Date: // Notary as to Owner and /or Condo President My Commission Expires: FEES: PERMIT 415i 5'5 RADON C.C.F. k% APPROVED: Fire Zoning Buildin Mechanical /0 N e' 7'8/4r Tax Folio 1/ S A4 J 3 if S-41 Competency # Ins.Co. NOTARY 15 TOTAL DUE Other Electrical Plumbing Engineering Master Permit #33 , 7 7 ( Phone S 3 I Address /Q A/• her 7cf Phone Estimated Cost(value) 2 4/4D •6L tar, as to My Commission ** PERMIT APPLICATION FOR MIAMI SHORES VILLAGE Date y'- -95 Job Address A9/144 t• ' t/' Tax Polio // .5 /3 ®fjZ Legal Description 1-07 /OW/ 7 Owner / Lessee / Tenant ) I67l e S rl `j 19 r-a Owner's Address lb /aa• L ") "o ' Contracting Co. 0 Z(/ /ltr Qualifier SS# - - Signature of owner and /or Condo President Date: Notary as to Owner and /or Condo President My Commission Expires: ** * * FEES: PERMIT RADON C.C.F. APPROVED: Fire Zoning Building AS".s'ee. 156 Address Master Permit # 33,,22 Phone '7J /— L// 3 G Phone State # Municipal # Competency # Ins.Co. Architect /Engineer Address Bonding Company Address Mortgagor Address Permit Type(circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN WORK DESCRIPTION 607V44.* -r a blr A h' Square Ft. 30 41(-)C Estimated Cost(value) ' O(W d1) WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT). Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated. Owner- Builder otary as to Owner- Builder My Commission Expires: AINSWORTH F. SMITH NotaW Public. S'te of Florida My comm. expires . 05, 199 No. CC184849 K Other Electrical Mechanical Plumbing Engineering EX /S-777.14 14/4-s-z- Re -40,9 4